Apparently May is "Mental Health Awareness" month, so let's get aware of what politicians are planning in terms of mental health care policy. Both congressional Democrats and Republicans are pushing mental health care bills right now. But while the Republican-led legislation has drawn widespread support, the Democrats' version, introduced by Rep. Ron Barber (D-Ariz.) this week, is getting a much less enthusiastic response. Many have slammed the bill—which Rep. Nancy Pelosi (D-Calif.) is said to have had a large hand in crafting—as a "stripped down, politically orchestrated" version of the measure Republican Rep. Tim Murphy, a clinical psychologist from Pennsylvania, introduced in December 2013.
Murphy's multifaceted bill, called the "Helping Families in Mental Health Crisis Act" (H.R. 3717), has the support of the American Psychological Association, the American Psychiatric Association, the National Alliance on Mental Illness, and many other medical groups. The Washington Post editorial board also supports Murphy's measure, writing in an April 16 editorial that it was "more comprehensive than other recent efforts to reform the system and perhaps has the brightest prospects in a divided Congress." Of the bill's 77 co-sponsors, one third are Democrats.
"The bill would reorganize the billions the federal government pours into mental health services, prioritizing initiatives backed by solid evidence and tracking their success," explained the Post. It would do so by creating an assistant secretary of mental health and substance abuse disorders to control mental health funding, thereby shifting power away from the Substance Abuse and Mental Health Services Administration (SAMHSA), which currently administers state mental health grants.
Murphy's measure would also change Medicaid to allow psychiatric hospitals to be reimbursed for short-term stays. It would make it easier for families of mentally ill patients, particularly younger patients, to obtain medical info from doctors and records. And it pushes states to adopt policies allowing judges to compel severely mentally-ill people into involuntary treatment.
This last bit has been the most controversial. Critics of Murphy's bill have focused on the way it expands the control that families and the state have over the treatment of severely mentally-ill individuals. They also say the bill ignores community treatment programs aimed at reaching people with mental disorders before things get out of control.
"We do not see those aims as mutually exclusive, and neither do the bill's backers," the Post's editorial board wrote. One might also point out that current-style efforts to reach people before it's too late haven't been so hot.
But the Democrats' bill, called "The Strengthening Mental Health in Our Communities Act," is largely focused on such efforts. It would increase mental health funding for various groups (schools, veterans, community organizations). It would also reauthorize the SAMHSA, create a White House Office for Mental Health Policy to run it, and require Medicare to cover longer hospital stays for mental health care hospitalizations.
"It has more candy for the mental health industry than Murphy's bill and stripped out all the programs that help those with the most serious mental illnesses," said DJ Jaffe, executive director for the New York-based Mental Illness Policy Organization.
In a Wall Street Journal op-ed, Kim Strassel called the Democrats introduction of the competing bill "the basest form of politics." Strassel suggested the measure is not just a ploy to kill Murphy's bill, but also to prop up the idea of gun control as the one true solution to serious mental illness. Mental health advocates told USA Today they're simply worried that the new bill will shift enough support away from Murphy's bill that neither will get anywhere.